Using a Very Low Energy Diet to Achieve Substantial Preconception Weight Loss in Women with Obesity: A Review of the Safety and Efficacy
Abstract
:1. Introduction
2. Basic Principles of the Use of Ketogenic Diets for Weight Loss
2.1. Definition of Ketogenic Diet
2.2. Importance of Nutritional Composition of Ketogenic Diets
2.3. Ketosis over the Course of a Ketogenic Dietary Program
2.4. Ketosis in the Pre-Pregnancy Period
2.5. Ketosis in Pregnancy
3. Rationale for Suitability of a VLED Diet in the Pre-Pregnancy Setting
3.1. Rationale for Suitability
3.2. Tolerability and Acceptability of VLEDs in Women Planning Pregnancy
3.3. VLEDs Support Maternal Nutrition
3.4. VLEDs Engage Patients in Pre-Pregnancy Weight Loss
4. Rationale for Concerns about a VLED in the Pre-Pregnancy Setting
4.1. Neurological Effects of Ketosis on the Fetus
4.2. Metabolic Effects of VLED on the Fetus
4.3. Growth Effects of VLEDs on the Fetus
4.4. Weight Maintenance after a VLED Program
5. Recommendations and Further Research
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Author, Year. | Study Design | Sample Size (Case/Control) | Cohort | Designed to Achieve Ketosis | Duration VLED (Wks) | Duration wt Maintenance (Wks) | Weight Loss (kg) (Case/Control) | Pregnancy Rate (%) (Case/Control) | Live Birth Rate (%) (Case/Control) | Pregnancy Outcomes Reported (Y/N) |
---|---|---|---|---|---|---|---|---|---|---|
Tsagareli et al., 2006 [71]. | Pilot | N = 10 | IVF | Y | 3–6 | 0 | 5.6 | 0 | 0 | N |
Moran et al., 2011 [72]. | RCT | N = 46 (21/25) | IVF | N | 7 | 0 | 3.8 ± 3.0/ 0.5 ± 1.2 | 67/40 | 39/25 | N |
Sim et al., 2014 [73]. | RCT | N = 49 (27/22) | IVF | Y | 6 | 6 | 6.6 ± 4.6/ 1.6 ± 3.6 | 48/14 | 44/14 | N |
Einarsson et al., 2017 & 2018 [74,75]. | RCT | N = 317 (160/157) | IVF | Y | 16 | 2–5 | 9.44 ± 6.57/ 1.19 ± 1.95 | Not specified | 45/41 | Y |
Rothberg et al., 2016 [76]. | Pilot | N = 14 | Prepreg | Y | 12 | 4 | 14 ± 6/ 5 ± 5 | 3/0 | 3/0 | N |
Brackenridge et al., 2018 [77]. | Pilot | N = 14 (6/8) | Prepreg | N | 26 | 0 | 17.1/2.7 | Not specified | Not specified | N |
Price et al., 2021 [78]. | RCT | N = 164 (85/79) | Prepreg | Y | 12 | 4 | 13.0/3.2 | 67/46 | 43/28 | Y |
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Price, S.A.; Sumithran, P. Using a Very Low Energy Diet to Achieve Substantial Preconception Weight Loss in Women with Obesity: A Review of the Safety and Efficacy. Nutrients 2022, 14, 4423. https://doi.org/10.3390/nu14204423
Price SA, Sumithran P. Using a Very Low Energy Diet to Achieve Substantial Preconception Weight Loss in Women with Obesity: A Review of the Safety and Efficacy. Nutrients. 2022; 14(20):4423. https://doi.org/10.3390/nu14204423
Chicago/Turabian StylePrice, Sarah A, and Priya Sumithran. 2022. "Using a Very Low Energy Diet to Achieve Substantial Preconception Weight Loss in Women with Obesity: A Review of the Safety and Efficacy" Nutrients 14, no. 20: 4423. https://doi.org/10.3390/nu14204423